Question

A 69 year old male patient arrives at the Emergency Department very short of breath and states that this has gotten progressively worse the past five days. He also reports that the shortness of breath is worse when lays down or with activity. He has a cough, especially at night and his wife has noted increased swelling in his legs bilaterally and mild substernal chest pressure.

The patient has a history of hypertension, smokes, drinks 1 beer a day, has allergies, and he is a farmer.   His vital signs are as follows: blood pressure 210/106, heart rate 118, respiratory rate 26, temperature 98.2 and his oxygen saturation is 89%. When assessing his breath sounds, crackles are noted in the lung bases bilaterally, he has 2+ pitting edema in the lower extremities bilaterally and his color is pale.   

Questions:? EXPLAIN IN FULL DETAIL
1. What are the priority assessments to report to the physician regarding the patients respiratory problems.
?2. Analyze the patient’s vital signs. Which vital sign parameters are of greatest concern?
?3. What do the presence of crackles in the lungs indicate??
4. What items in the patient’s history might be contributing to his respiratory distress?
5. What other questions might you ask this patient to help you have more information about his condition?
?6. The physician orders oxygen for the patient, what physical assessment parameters made a case of the physician ordering the oxygen?
7. The oxygen has been on for an hour. Describe the physical assessment parameters you would expect to see improvement in now that the oxygen has been on for an hour.

Answer 1

Answers 1 priority .

Priority assessment to the physician to report about respiratory infection is the following

• Short ness of breath progressive worsen the past 5days
• He also report that shortness of breahbr,i s worsen when lays down.

He has cough especially at night time and swelling in his legs bilateral ly and mild substernal chest pressure.

Answer 2.

1. The patient vital signs are Bp is 210/160mmof hg
2. The patient heart rate is 118bt/min
3. Respiration rate is 26bre/min
4. Body temperature is 98.2

So we should observe the blood pressure which one is very high in the following above.

Ansewr3.

Crackle are the sounds you will hear in the lungs field that has fluid in small airway .

• The crackle indicates the presence of pneumonia,bronchitis,atelectasis.
  • Answers 4

1. T he patient with the history of shortness of breath before 5days
2. He has cough especially at night time.

• Answers 5.
• As the nurses I will collect the past history of using medication
• The patient having any hereditary history of shortness of breath.

Consumption of alcohol and tobacco consumption.

Answers 6.

• Because of the patient having less oxygen saturation is 89% with this reason the physician ordered to provide oxygen therapy.
• Answer 7.
• The patient having trouble in the lungs field with the fluid so patient needs more oxygen therapy in order to improve the patent condition i.e15lit/but.